Working Mom Can't Nurse on Demand

Q: I read the following story in the paper: "mothers should try to breast-feed their babies exclusively for at least a year if not longer, the largest U.S. pediatricians' group said yesterday, strongly reaffirming its policy favoring the practice." My daughter recently had her second child, and after eight weeks has had to return to work and simply cannot breast-feed exclusively. So as a pediatrician, what is your advice for young moms who must work and cannot be available to nurse on demand for 12 months?

A: There is no question that human milk is superior for infant feeding. It provides advantages for growth, development, and general health, while significantly decreasing the chances for some diseases. There are also studies that indicate possible health benefits for the mother.

The American Academy of Pediatrics clearly emphasizes that breast feeding is the ideal method that will help children achieve optimal health, growth, and development.

Pediatricians should promote and support breast feeding, as soon as possible after birth. Mothers need to feel comfortable feeding and pumping anywhere. Nursing mothers should be supported to breast feed at home or at work. A mother in the right settings can pump her breasts and have a caretaker feed the breast milk, if necessary, while mom's at work. There are many wonderful resources available to answer questions and meet individual needs.

You raise a concern that is shared by many others. As a pediatrician, I believe it is extremely important that the bond between mom and baby be supported, particularly with economic decisions often forcing many mothers back into the working world before a year is up. Although we would love to increase the number of women starting and continuing to breast feed, it is not always possible. Despite demonstrated benefits of breast feeding, there are some situations in which breast feeding may not work for you. It is ultimately the mother's decision on what fits best into her family situation. Your daughter need not feel guilty.

Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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